PICU Skills Checklist Date:* Name: (First, MI, Last)* Email CARDIOVASCULARAssessment:* N/A Inexperienced Limited Experience Experienced Highly Experienced Auscultation (Rate, Rhythm, Volume):* N/A Inexperienced Limited Experience Experienced Highly Experienced Blood Pressure (Doppler/Dynamap):* N/A Inexperienced Limited Experience Experienced Highly Experienced Heart Sounds/Murmurs:* N/A Inexperienced Limited Experience Experienced Highly Experienced Perfusion:* N/A Inexperienced Limited Experience Experienced Highly Experienced Interpretation of Lab Results:* N/A Inexperienced Limited Experience Experienced Highly Experienced CBC:* N/A Inexperienced Limited Experience Experienced Highly Experienced Electrolytes:* N/A Inexperienced Limited Experience Experienced Highly Experienced Equipment & Procedures:* N/A Inexperienced Limited Experience Experienced Highly Experienced Arrhythmia Interpretation:* N/A Inexperienced Limited Experience Experienced Highly Experienced Defibrillation/Cardioversion:* N/A Inexperienced Limited Experience Experienced Highly Experienced Invasive Hemodynamic Monitoring Values:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Pediatric Patient with:* N/A Inexperienced Limited Experience Experienced Highly Experienced Cardiac Transplant:* N/A Inexperienced Limited Experience Experienced Highly Experienced Cardiogenic Shock:* N/A Inexperienced Limited Experience Experienced Highly Experienced Cardiomyopathy:* N/A Inexperienced Limited Experience Experienced Highly Experienced Congenital Heart Disease/Defects/Repair:* N/A Inexperienced Limited Experience Experienced Highly Experienced Endocarditis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Hypovolemic Shock:* N/A Inexperienced Limited Experience Experienced Highly Experienced Post-Cardiac Arrest:* N/A Inexperienced Limited Experience Experienced Highly Experienced Post-Cardiac Surgery (Directly from OR):* N/A Inexperienced Limited Experience Experienced Highly Experienced Post-Cardiac Surgery (NOT Directly from OR):* N/A Inexperienced Limited Experience Experienced Highly Experienced Post-Diagnostic/Interventional Cardiac Cath:* N/A Inexperienced Limited Experience Experienced Highly Experienced Medications:* N/A Inexperienced Limited Experience Experienced Highly Experienced Antiarrhythmics (Amiodarone, Lidocaine, Procainamide):* N/A Inexperienced Limited Experience Experienced Highly Experienced Digoxin (Lanoxin):* N/A Inexperienced Limited Experience Experienced Highly Experienced Dobutamine (Dobutrex):* N/A Inexperienced Limited Experience Experienced Highly Experienced Dopamine (Intropin):* N/A Inexperienced Limited Experience Experienced Highly Experienced Epinephrine (Adrenalin):* N/A Inexperienced Limited Experience Experienced Highly Experienced Sodium Bicarbonate:* N/A Inexperienced Limited Experience Experienced Highly Experienced PULMONARYInterpretation of ABGs:* N/A Inexperienced Limited Experience Experienced Highly Experienced Assessment* N/A Inexperienced Limited Experience Experienced Highly Experienced Breath Sounds/Rate & Work:* N/A Inexperienced Limited Experience Experienced Highly Experienced Rate & Work of Breathing:* N/A Inexperienced Limited Experience Experienced Highly Experienced Equipment & Procedures* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with Intubation/Extubation:* N/A Inexperienced Limited Experience Experienced Highly Experienced CPAP/Nasal CPAP/BIPAP:* N/A inexperienced Limited Experience Experienced Highly Experienced Endotracheal Tube Stabilization:* N/A Inexperienced Limited Experience Experienced Highly Experienced Endotracheal Tube Suctioning-Inline:* N/A Inexperienced Limited Experience Experienced Highly Experienced Endotracheal Tube Suctioning-Open:* N/A Inexperienced Limited Experience Experienced Highly Experienced Tracheostomy Care/Suctioning:* N/A Inexperienced Limited Experience Experienced Highly Experienced Apnea Monitoring:* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with Chest Tube Placement:* N/A Inexperienced Limited Experience Experienced Highly Experienced Chest Tube Management/Removal:* N/A Inexperienced Limited Experience Experienced Highly Experienced ECMO (Extracorporeal Membrane Oxygenation):* N/A Inexperienced Limited Experience Experienced Highly Experienced End Tidal CO2 Monitoring:* N/A Inexperienced Limited Experience Experienced Highly Experienced Nebulizer:* N/A Inexperienced Limited Experience Experienced Highly Experienced Pulse Oximetry:* N/A Inexperienced Limited Experience Experienced Highly Experienced Thoracentesis:* N/A Inexperienced Limited Experience Experienced Highly Experienced O2 Therapy Delivery-Non Ventilator* N/A Inexperienced Limited Experience Experienced Highly Experienced Bag and Mask:* N/A Inexperienced Limited Experience Experienced Highly Experienced Nasal Cannula/Oxyhood/Tent:* N/A Inexperienced Limited Experience Experienced Highly Experienced Trach Collar:* N/A Inexperienced Limited Experience Experienced Highly Experienced Ventilator* N/A Inexperienced Limited Experience Experienced Highly Experienced CPAP/PEEP:* N/A Inexperienced Limited Experience Experienced Highly Experienced High Frequency/Jet Ventilator:* N/A Inexperienced Limited Experience Experienced Highly Experienced Oscillating Ventilator:* N/A Inexperienced Limited Experience Experienced Highly Experienced IMV/SIMV:* N/A Inexperienced Limited Experience Experienced Highly Experienced Pressure/Volume Ventilator:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Pediatric Patient with* N/A Inexperienced Limited Experience Experienced Highly Experienced Chronic Respiratory Disease:* N/A Inexperienced Limited Experience Experienced Highly Experienced ENT Surgery:* N/A Inexperienced Limited Experience Experienced Highly Experienced Epiglottitis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Flail Chest:* N/A Inexperienced Limited Experience Experienced Highly Experienced Foreign Body Aspiration:* N/A Inexperienced Limited Experience Experienced Highly Experienced Fresh Tracheostomy:* N/A Inexperienced Limited Experience Experienced Highly Experienced Hemothorax/Pneumothorax:* N/A Inexperienced Limited Experience Experienced Highly Experienced Laryngotracheobronchitis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Pneumonia:* N/A Inexperienced Limited Experience Experienced Highly Experienced RDS:* N/A Inexperienced Limited Experience Experienced Highly Experienced Reactive Airway Disease:* N/A Inexperienced Limited Experience Experienced Highly Experienced Medication* N/A Inexperienced Limited Experience Experienced Highly Experienced Inhaled Bronchodilators:* N/A Inexperienced Limited Experience Experienced Highly Experienced Inhaled Steroids:* N/A Inexperienced Limited Experience Experienced Highly Experienced IV/Oral Steroids:* N/A Inexperienced Limited Experience Experienced Highly Experienced Racemic Epinephrine:* N/A Inexperienced Limited Experience Experienced Highly Experienced NEUROLOGICALAssessment* N/A Inexperienced Limited Experience Experienced Highly Experienced Glasgow Coma Scale:* N/A Inexperienced Limited Experience Experienced Highly Experienced Neuro Assesssment:* N/A Inexperienced Limited Experience Experienced Highly Experienced Pathologic Reflexes:* N/A Inexperienced Limited Experience Experienced Highly Experienced Equipment & Procedures* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with Lumbar Puncture:* N/A Inexperienced Limited Experience Experienced Highly Experienced Hypo/Hyperthermia Blanket:* N/A Inexperienced Limited Experience Experienced Highly Experienced Seizure Precautions:* N/A Inexperienced Limited Experience Experienced Highly Experienced Spinal Precautions:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Pediatric Patient with* N/A Inexperienced Limited Experience Experienced Highly Experienced Brain Death/Organ Procurement:* N/A Inexperienced Limited Experience Experienced Highly Experienced Closed Head Injury:* N/A Inexperienced Limited Experience Experienced Highly Experienced Coma:* N/A Inexperienced Limited Experience Experienced Highly Experienced DI/SIADH:* N/A Inexperienced Limited Experience Experienced Highly Experienced Encephalitis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Externalized VP Shunts:* N/A Inexperienced Limited Experience Experienced Highly Experienced Increased ICP/ICP Monitoring:* N/A Inexperienced Limited Experience Experienced Highly Experienced Meningitis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Neuromuscular Disease:* N/A Inexperienced Limited Experience Experienced Highly Experienced Post-Craniotomy:* N/A Inexperienced Limited Experience Experienced Highly Experienced Seizures:* N/A Inexperienced Limited Experience Experienced Highly Experienced Spinal Cord Injury:* N/A Inexperienced Limited Experience Experienced Highly Experienced Medications* N/A Inexperienced Limited Experience Experienced Highly Experienced Dilantin (Phenytoin):* N/A Inexperienced Limited Experience Experienced Highly Experienced Haldol (Haloperidol):* N/A Inexperienced Limited Experience Experienced Highly Experienced Mannitol:* N/A Inexperienced Limited Experience Experienced Highly Experienced Paralytics:* N/A Inexperienced Limited Experience Experienced Highly Experienced Pitressin (Vasopressin):* N/A Inexperienced Limited Experience Experienced Highly Experienced ORTHOPEDICSEquipment & Procedures* N/A Inexperienced Limited Experience Experienced Highly Experienced Specialized Orthopedic Beds:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Pediatric Patient with* N/A Inexperienced Limited Experience Experienced Highly Experienced Traction - Cervical:* N/A Inexperienced Limited Experience Experienced Highly Experienced Traction - Bucks/Skeletal:* N/A Inexperienced Limited Experience Experienced Highly Experienced Post-Vertebral Surgery:* N/A Inexperienced Limited Experience Experienced Highly Experienced GASTROINTESTINALAssessment* N/A Inexperienced Limited Experience Experienced Highly Experienced Abdominal:* N/A Inexperienced Limited Experience Experienced Highly Experienced Nutritional:* N/A Inexperienced Limited Experience Experienced Highly Experienced Equipment & Procedures:* N/A Inexperienced Limited Experience Experienced Highly Experienced Abdominal Decompression Devices:* N/A Inexperienced Limited Experience Experienced Highly Experienced Feedings:* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with Breast Feeding/Storage & Handling of Breast Milk:* N/A Inexperienced Limited Experience Experienced Highly Experienced Bottle Feeding:* N/A Inexperienced Limited Experience Experienced Highly Experienced Gavage Feedings:* N/A Inexperienced Limited Experience Experienced Highly Experienced Placement & Management of GI Tubes:* N/A Inexperienced Limited Experience Experienced Highly Experienced Gastrostomy/Button:* N/A Inexperienced Limited Experience Experienced Highly Experienced Jejunostomy:* N/A Inexperienced Limited Experience Experienced Highly Experienced Nasogastric/Orogastric:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Pediatric Patient with:* N/A Inexperienced Limited Experience Experienced Highly Experienced Fresh Ostomy:* N/A Inexperienced Limited Experience Experienced Highly Experienced Gastroenteritis/Severe Dehydration:* N/A Inexperienced Limited Experience Experienced Highly Experienced GE Reflux:* N/A Inexperienced Limited Experience Experienced Highly Experienced GI Bleeding:* N/A Inexperienced Limited Experience Experienced Highly Experienced Hepatic Failure:* N/A Inexperienced Limited Experience Experienced Highly Experienced Hepatitis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Pancreatitis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Post-Abdominal Surgery:* N/A Inexperienced Limited Experience Experienced Highly Experienced CAVH:* N/A Inexperienced Limited Experience Experienced Highly Experienced Hemodialysis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Hydronephrosis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Nephritis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Nephrotic Syndrome:* N/A Inexperienced Limited Experience Experienced Highly Experienced Peritoneal Dialysis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Post-Renal Transplant:* N/A Inexperienced Limited Experience Experienced Highly Experienced ENDOCRINE/METABOLICEquipment & Procedures:* N/A Inexperienced Limited Experience Experienced Highly Experienced Bedside Blood Glucose Monitoring:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Pediatric Patient with:* N/A Inexperienced Limited Experience Experienced Highly Experienced Hypo/Hyperglycemia:* N/A Inexperienced Limited Experience Experienced Highly Experienced Hyperbilirubinemia:* N/A Inexperienced Limited Experience Experienced Highly Experienced Medication:* N/A Inexperienced Limited Experience Experienced Highly Experienced Insulin:* N/A Inexperienced Limited Experience Experienced Highly Experienced Dextrose:* N/A Inexperienced Limited Experience Experienced Highly Experienced WOUND MANAGEMENTAssessment:* N/A Inexperienced Limited Experience Experienced Highly Experienced Skin for Impending Breakdown:* N/A Inexperienced Limited Experience Experienced Highly Experienced Surgical Wound Healing:* N/A Inexperienced Limited Experienced Experienced Highly Experienced Equipment & Procedures:* N/A Inexperienced Limited Experience Experienced Highly Experienced Specialty Beds:* N/A Inexperienced Limited Experience Experienced Highly Experienced Sterile Dressing Changes:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Patient with:* N/A Inexperienced Limited Experience Experienced Highly Experienced Burns:* N/A Inexperienced Limited Experience Experienced Highly Experienced Decubitus Ulcers:* N/A Inexperienced Limited Experience Experienced Highly Experienced Staged Decubitus Ulcers:* N/A Inexperienced Limited Experience Experienced Highly Experienced Surgical Wounds with Drains:* N/A Inexperienced Limited Experience Experienced Highly Experienced Vacuum Assisted Devices (VAD):* N/A Inexperienced Limited Experience Experienced Highly Experienced ONCOLOGYInterpretation of Lab Results:* N/A Inexperienced Limited Experience Experienced Highly Experienced Blood Counts:* N/A Inexperienced Limited Experience Experienced Highly Experienced Equipment & Procedures:* N/A Inexperienced Limited Experience Experienced Highly Experienced Reverse Isolation:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Pediatric Patient with:* N/A Inexperienced Limited Experience Experienced Highly Experienced Acute Tumor Lysis Syndrome:* N/A Inexperienced Limited Experience Experienced Highly Experienced Bone Marrow Transplant:* N/A Inexperienced Limited Experience Experienced Highly Experienced Disseminated Intravascular Coagulation:* N/A Inexperienced Limited Experience Experienced Highly Experienced Inpatient Chemotherapy:* N/A Inexperienced Limited Experience Experienced Highly Experienced Inpatient Hospice:* N/A Inexperienced Limited Experience Experienced Highly Experienced Leukemia:* N/A Inexperienced Limited Experience Experienced Highly Experienced Malignant Tumors:* N/A Inexperienced Limited Experience Experienced Highly Experienced Radiation Implants:* N/A Inexperienced Limited Experience Experienced Highly Experienced Sickle Cell Anemia:* N/A Inexperienced Limited Experience Experienced Highly Experienced Medication:* N/A Inexperienced Limited Experience Experienced Highly Experienced Chemotherapy:* N/A Inexperienced Limited Experience Experienced Highly Experienced INFECTIOUS DISEASEInterpretation of Lab Results:* N/A Inexperienced Limited Experience Experienced Highly Experienced CBC/Differential:* N/A Inexperienced Limited Experience Experienced Highly Experienced Culture Reports:* N/A Inexperienced Limited Experience Experienced Highly Experienced Equipment & Procedures:* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with Lumbar Puncture:* N/A Inexperienced Limited Experience Experienced Highly Experienced Collect Culture Specimens:* N/A Inexperienced Limited Experience Experienced Highly Experienced Isolation Techniques:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Pediatric Patient with:* N/A Inexperienced Limited Experience Experienced Highly Experienced Immunosuppressive Disorder:* N/A Inexperienced Limited Experience Experienced Highly Experienced Meningitis:* N/A Inexperienced Limited Experience Experienced Highly Experienced Pyelonephritis:* N/A Inexperienced Limited Experience Experienced Highly Experienced RSV:* N/A Inexperienced Limited Experience Experienced Highly Experienced Septic Shock:* N/A Inexperienced Limited Experience Experienced Highly Experienced Tuberculosis:* N/A Inexperienced Limited Experience Experienced Highly Experienced PHLEBOTOMY/IV THERAPYEquipment & Procedures:* N/A Inexperienced Limited Experience Experienced Highly Experienced Administration of Blood/Blood Products:* N/A Inexperienced Limited Experience Experienced Highly Experienced Starting IVs:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Patient with:* N/A Inexperienced Limited Experience Experienced Highly Experienced A Lines/Dressings:* N/A Inexperienced Limited Experience Experienced Highly Experienced CVP Lines/Dressings:* N/A Inexperienced Limited Experience Experienced Highly Experienced PA Lines/Dressings:* N/A Inexperienced Limited Experience Experienced Highly Experienced PICC Lines/Dressings:* N/A Inexperienced Limited Response Experienced Highly Experienced Implantable Ports/Dressing:* N/A Inexperienced Limited Experience Experienced Highly Experienced PAIN MANAGEMENTAssessment of Pain Level:* N/A Inexperienced Limited Experience Experienced Highly Experienced Assessment of Response to Pain Management Interventions:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Patient with:* N/A Inexperienced Limited Experience Experienced Highly Experienced Epidural Anesthesia/Analgesia:* N/A Inexperienced Limited Experience Experienced Highly Experienced Moderate Sedation:* N/A Inexperienced Limited Experience Experienced Highly Experienced MISCELLANEOUSNational Patient Safety Goals:* N/A Inexperienced Limited Experience Experienced Highly Experienced Knowledge of Normal Growth & Development:* N/A Inexperienced Limited Experience Experienced Highly Experienced Recognize/Report Signs of Abuse:* N/A Inexperienced Limited Experience Experienced Highly Experienced Restraint Use:* N/A Inexperienced Limited Experience Experienced Highly Experienced Equipment & Procedures:* N/A Inexperienced Limited Experience Experienced Highly Experienced Charge Experience:* N/A Inexperienced Limited Experience Experienced Highly Experienced Computerized Charting:* N/A Inexperienced Limited Experience Experienced Highly Experienced Preceptor Experience:* N/A Inexperienced Limited Experience Experienced Highly Experienced Pyxis Medication Admin. System:* N/A Inexperienced Limited Experience Experienced Highly Experienced Other Medication Admin. System:* N/A Inexperienced Limited Experience Experienced Highly Experienced Computerized Charting:* N/A Inexperienced Limited Experience Experienced Highly Experienced Cerner:* N/A Inexperienced Limited Experience Experienced Highly Experienced Eclipsys:* N/A Inexperienced Limited Experience Experienced Highly Experienced Epic:* N/A Inexperienced Limited Experience Experienced Highly Experienced GE:* N/A Inexperienced Limited Experience Experienced Highly Experienced McKesson:* N/A Inexperienced Limited Experience Experienced Highly Experienced Meditech:* N/A Inexperienced Limited Experience Experienced Highly Experienced Other:* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Pediatric Patient with:* N/A Inexperienced Limited Experience Experienced Highly Experienced Anorexia/Bulemia:* N/A Inexperienced Limited Experience Experienced Highly Experienced Blunt Trauma:* N/A Inexperienced Limited Experience Experienced Highly Experienced Craniofacial Reconstruction:* N/A Inexperienced Limited Experience Experienced Highly Experienced Near Drowning:* N/A Inexperienced Limited Experience Experienced Highly Experienced Overdose:* N/A Inexperienced Limited Experience Experienced Highly Experienced Penetrating Trauma:* N/A Inexperienced Limited Experience Experienced Highly Experienced Poison Ingestion:* N/A Inexperienced Limited Experience Experienced Highly Experienced Psychiatric Disorders:* N/A Inexperienced Limited Experience Experienced Highly Experienced Suicide Attempt/Ideation:* N/A Inexperienced Limited Experience Experienced Highly Experienced Medications:* N/A Inexperienced Limited Experience Experienced Highly Experienced Calculation of Drugs Delivered by IV Infusion:* N/A Inexperienced Limited Experience Experienced Highly Experienced Dosage Calculations:* N/A Inexperienced Limited Experience Experienced Highly Experienced Knowledge of Emergency Drugs Actions/Reactions:* N/A Inexperienced Limited Experience Experienced Highly Experienced Pediatric Drug Actions/Reactions:* N/A Inexperienced Limited Experience Experienced Highly Experienced Certifications/Licensures/RegistrationsBLS: MM slash DD slash YYYY NRP: MM slash DD slash YYYY PALS: MM slash DD slash YYYY ACLS: MM slash DD slash YYYY Other MM slash DD slash YYYY Areas of Expertise:Consent* By submitting this form, I agree to all terms and conditions and agree to authorize consent CommentsThis field is for validation purposes and should be left unchanged.